Question: Sorry about the long post, but I'm wondering if correcting a previous hair transplant surgery is possible. Between 1992 and 1996, I had five previous procedures which reconstructed the frontal area only. The area runs all the way around the hair line at about 1 inch in depth, maybe a little deeper along the temples. Mini and micro grafts were used, taken using the punch graft method, and the remaining holes were sutured up. I would like to have the old surgery fixed to give a more natural appearance, I've included pictures so that you can see what I'm talking about. I'm 36 years old, and have been using finesteride and rogain for many years which I think has worked so that I haven't lost any more hair. The areas where the grafts were taken from, three total, left the donor areas bumpy, some spots worse than others, which I'd like to have fixed or at least reduced. There is also an elevation of the tissue which received the grafts which I can feel and believe must be scar tissue under the skin, which I would not want to get worse with corrective surgery. I'm also concerned that if the previous plugs were removed there would be an added bumpiness in this area. Could you please tell me what can be done to fix this older surgery and what methods you might use, also an estimate of how many sessions it would take and what the cost might be? My main goal is to achieve a natural looking and feeling hairline, avoiding further scarring and bumpiness in the frontal area, and reducing the current bumpiness I have from my previous donor sites. I'm also wondering if the existing plug grafts can be redistributed, using FUE or FIT as some refer to it to remove individual hairs from them. Thank you.

Answer: There are several issues which seem to have resulted in the unnatural appearance that you have, all of which I believe can be addressed and improved upon. First, without the fine one hair grafts placed in an irregular fashion up front, your hairline appears too much like a straight line. The larger plug grafts that were used have created lumpy bumps or cobblestoning. Second, right behind the frontal one inch or so of the hairline, there is not enough density. This has left the scalp thinner, adding to that transplanted look. The last issue is the scarring of the donor site. Given this scarring, I would not recommend the FUE procedure for you, which uses grafts extracted one by one using tiny punches. There are several reasons why I would not recommend this procedure for you, including the limit on the number of grafts possible per procedure, the likely accidental transection of donor hairs, and more importantly the fact that the FUE procedure will only add, not subtract, from the donor site scarring. I believe that the best approach for you would involve the removal of donor grafts by a single donor strip. This would incorporate some of your prior scarring as portions of bumpy, scarred scalp would be removed and replaced with a single fine line closure similar to the results that I achieve using my state of the art follicular unit grafting procedures. Ultimately, I believe this would significantly lessen that transplanted appearance and greatly improve your appearance. Please feel free to call or email with any further questions.